Prolonged neuromuscular block in a preeclamptic patient induced by magnesium sulfate

• Published in: The Pan African medical journal Vol. 25; no. 5; p. 5
• Main Authors: Berdai, Mohamed Adnane, Labib, Smael, Harandou, Mustapha
• Format: Journal Article
• Language: English
• Published: Uganda African Field Epidemiology Network 2016; The African Field Epidemiology Network; The Pan African Medical Journal
• Subjects: Adult; Anesthesia, General - methods; Case Report; Case reports; Cesarean Section - methods; Female; HELLP Syndrome - physiopathology; Humans; magnesium sulfate; Magnesium Sulfate - administration & dosage; Magnesium Sulfate - adverse effects; Neostigmine - administration & dosage; neuromuscular block; Neuromuscular Blockade - methods; Nicardipine - therapeutic use; non depolarizing relaxants; Pre-Eclampsia - physiopathology; Pregnancy; neuromuscular block; Magnesium sulfate; non depolarizing relaxants; pregnancy
• ISSN: 1937-8688; 1937-8688
• DOI: 10.11604/pamj.2016.25.5.6616

Recent large use of magnesium in the obstetric population should incite anesthesiologists to control its side effects and drugs interactions. We report a case of a 30-year-old woman, with severe preeclampsia and HELLP syndrome, receiving sulfate magnesium and nicardipine, who underwent a cesarean section under general anesthesia. She developed a prolonged and deep neuromuscular blockade, which was antagonized three hours later with neostigmine. In case of therapeutic hypermagnesaemia, non-depolarizing relaxants must be used in reduced doses, and at increased time intervals, with appropriate neuromuscular monitoring.